Recurrent pulmonary arterial hypertension following neonatal treatment with extracorporeal membrane oxygenation.
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Combined Modality Therapy↗
Biomedical subjects
B G Landrum
Publications and source records attributed to B G Landrum.
Prophylactic furosemide in severe respiratory distress syndrome: blinded prospective study.
To further characterize the place for furosemide in the treatment of newborn infants with respiratory distress syndrome requiring mechanical ventilation, we conducted a blinded, prospective study comparing early prophylactic use (1 mg/kg every 12 hours for four doses beginning at 24 hours of age) with prn use of this drug. Prophylactic administration of furosemide produced no beneficial effect on any measure of pulmonary function compared with use of this drug as needed (prn). However, patients receiving the prophylactic furosemide regimen were found to have more rapid postnatal weight loss, higher pulse rate, and greater sympathomimetic drug requirement during the period of diuretic administration. Patients in the prophylactic group did not demonstrate the moderate expansion in plasma volume between 48 and 96 hours of age seen in the control group. These data suggest that the prophylactic regimen produced an undesirable degree of volume depletion. Further studies should be conducted to develop objective criteria for the selection of the subgroup of patients with respiratory distress syndrome who may benefit from furosemide.
Body Weight↗
Changes in bombesin, calcitonin, and serotonin immunoreactive pulmonary neuroendocrine cells in cystic fibrosis and after prolonged mechanical ventilation.
Increases in bombesin, calcitonin, and serotonin immunoreactive pulmonary neuroendocrine cells have been documented in infants with bronchopulmonary dysplasia. As some of the secretory products of these postulated airway chemoreceptors are known to adversely affect pulmonary vasomotor and bronchomotor tone, the present study was undertaken to determine if similar changes occur in the lungs of older pediatric patients with chronic respiratory disease. Immunoreactive cells were identified using the antibody-peroxidase-antiperoxidase technique and expressed as immunoreactive bronchioles/cm2 of lung tissue. In subjects dying an accidental or noncardiopulmonary death (control group: n = 48, zero to 24 yr of age), the total number of bombesin, calcitonin, and serotonin immunoreactive bronchioles/cm2 was greatest at birth, then decreased rapidly to extremely low levels after the first year of life. In the cystic fibrosis (n = 55, 3 days to 29 yr of age) and prolonged ventilation (n = 24, 4 months to 18 yr of age) groups, there was a significant increase (p less than 0.035) in bombesin, calcitonin, and serotonin immunoreactive bronchioles/cm2 from 1 to 11 yr of age. In the cystic fibrosis group, there was a sixfold increase in the number of serotonin immunoreactive bronchioles/cm2 lung tissue (p less than 0.015) compared with that in the other 2 groups during the first decade of life, suggesting a response to specific factors present only in the lungs of patients with this disease. In all 3 groups, immunoreactive cells were infrequently identified after 11 yr, implying a fundamental change in neuroendocrine cell biology coincident with the termination of lung growth and/or the onset of puberty.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Hydrops fetalis and chromosomal trisomies.
Three patients with trisomy 21 and one with trisomy 13 associated with nonimmunologic hydrops fetalis are presented. Analysis of previous nonimmunologic hydrops fetalis, which included chromosomal trisomies, and the present study yields an overall incidence of 7% for chromosomal trisomy disorders in live-born infants with nonimmunologic hydrops fetalis. Our data emphasize the need for chromosomal analysis of neonates with nonimmunologic hydrops fetalis.
Chromosomes, Human, 13-15↗
Pleural drainage using modified pigtail catheters.
An 8.3-Fr modified pigtail catheter has been developed for chronic percutaneous drainage of pericardial effusions. Placement of this catheter using a modified Seldinger technique is virtually atraumatic. To test the safety and efficacy of this catheter for pleural drainage, it was used to manage eight collections of pleural fluid and nine pneumothoraces in a total of 12 infants and children. There were no placement complications. Fluid accumulations were satisfactorily drained in every instance. Pneumothoraces were treated definitively with a single catheter, except when a bronchopleural fistula was present. Percutaneous pigtail drainage of pleura fluid or air is simple, safe, effective, and substantially less traumatic than standard chest-tube placement.
Catheters, Indwelling↗